Early prevention efforts involving parents have the potential of reducing alcohol, tobacco and other drug (ATOD) use among youth. The purpose of this study is to test the effects of a school and home-based parent-child ATOD prevention program on reducing child, family and parent risk factors for ATOD use. Specific aims are to: a) refine and further develop the home-based portion of the expanded Beginning Alcohol and Addictions Basic Education Studies (BABES) intervention; and, b) test the effects of the expanded version of BABES on reducing child, family and parent risk factors for ATOD use among kindergarten children from high-risk schools, in comparison to the traditional BABES program and to a control group. Ten parents who participated in the BABES program will be recruited to take part in a focus group to evaluate the content and clarity of the home-based portion of the expanded BABES program. The home-based portion will be revised based on the focus group data. An experimental three group pre-test/post-test design will be used with 150 parent-child dyads from three randomly selected high-risk elementary schools. Schools will be randomly assigned to one of three groups: a) expanded BABES with the school and home parent-child interaction component (12 sessions); b) traditional BABES (7 sessions); and c) no BABES (control). Pre-test data on child, family and parent variables will be obtained from parents during in-home interviews. Pre-test data on children's behavior will be collected from teachers and parents. Children will be interviewed to assess their baseline knowledge and attitudes about ATOD use. School nurses certified as BABES presenters will deliver the expanded and traditional BABES programs. Undergraduate nursing students will collect data with children and assist in delivery of the expanded BABES program. Post-test data will be collected from parents, teachers and children at 1-month and 6-month follow-ups. Findings may support the efficacy of this early prevention intervention in reducing child, family and parent risk factors associated with subsequent ATOD use by youth.